Cookies on the NHS website
We've put some small files called cookies on your device to make our site work.
We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
I'm OK with analytics cookies Do not use analytics cookies
Search the NHS website
Search
My account
Health A-Z
Live Well
Mental health
Care and support
Pregnancy
Browse
More
Home Health A to Z
Kwashiorkor
Kwashiorkor is a severe form of malnutrition. It's most common in some developing regions where babies and children do not get enough protein or other essential nutrients in their diet.
The main sign of kwashiorkor is too much fluid in the body's tissues, which causes swelling under the skin (oedema). It usually begins in the legs, but can involve the whole body, including the face.
Symptoms of kwashiorkor
As well as oedema, symptoms of kwashiorkor can include:
loss of muscle mass
an enlarged tummy ("pot belly")
regular infections, or more serious or long-lasting infections
red, inflamed patches of skin that darken and peel or split open
dry, brittle hair that falls out easily and may lose its colour
failure to grow in height
tiredness or irritability
ridged or cracked nails
Kwashiorkor can be fatal if it's left untreated for too long because children become very vulnerable to infections.
What causes kwashiorkor?
The main cause of kwashiorkor is not eating enough protein or other essential vitamins and minerals.
It's most common in developing countries with a limited food supply, poor hygiene, and a lack of education about the importance of giving babies and children an adequate diet.
Kwashiorkor is rare in developed countries such as the UK, but it can occasionally happen as a result of severe neglect, long-term illness, a lack of knowledge about good nutrition, or a very restricted diet.
Although kwashiorkor can affect people of all ages, it's more common in children than adults.
Diagnosing kwashiorkor 
Kwashiorkor can often be diagnosed based on a child's physical appearance and questions about their diet and care.
However, a blood test and urine test may be done to rule out other conditions. This can include tests to:
measure blood sugar and protein levels
check how well the liver and kidneys are working by testing the urine and blood for anaemia
measure the levels of vitamins and minerals in the body
Other tests may include growth measurements, calculating body mass index (BMI), measuring body water content, taking a sample of skin (biopsy) or hair for testing.
Treating kwashiorkor 
If kwashiorkor is found early, it can be treated with either specially formulated milk-based feeds or ready-to-use therapeutic food (RUTF).
RUTF is typically made up of peanut butter, milk powder, sugar, vegetable oil, and added vitamins and minerals.
More intensive treatment in hospital is needed in severe cases or where there are already complications, such as infections.
Hospital treatment usually involves:
treating or preventing low blood glucose
keeping the person warm – kwashiorkor can make it harder to generate body heat
treating dehydration with specially formulated rehydration solution
treating infections with antibiotics – kwashiorkor greatly increases the risk of infections
treating vitamin and mineral deficiencies – vitamin supplements are usually included in the special milk feeds and RUTF
slowly introducing small amounts of food, then gradually increasing the amount of food
The treatment usually takes 2 to 6 weeks.
Recovering from kwashiorkor
How well a person recovers from kwashiorkor depends on how severe their symptoms were when treatment began. 
If treatment was started early, the person will usually recover well, although children may never reach their full growth potential and be shorter than their peers.
If treatment was started in the later stages of protein malnutrition, the person may be left with physical and intellectual disabilities.
If kwashiorkor is not treated or treatment is significantly delayed, it can lead to death.
Marasmus
Marasmus is another type of malnutrition that can affect young children in regions of the world where there's an unstable food supply.
Signs of marasmus include thinness and loss of fat and muscle without any tissue swelling (oedema).
Like kwashiorkor, marasmus is caused by a lack of the right types of nutrients. Tests may need to be done to rule out other causes of thinness. The treatment for marasmus is similar to that for kwashiorkor.
Page last reviewed: 28 August 2019
Next review due: 28 August 2022
Support links
Home
Health A to Z
Live Well
Mental health
Care and support
Pregnancy
NHS services
Coronavirus (COVID-19)
NHS App
Find my NHS number
Your health records
About the NHS
Healthcare abroad
Contact us
Other NHS websites
Profile editor login
About us
Accessibility statement
Our policies
Cookies
© Crown copyright